What are some tips or strategies for coping with the ongoing fear of relapse?

What are some tips or strategies for coping with the ongoing fear of relapse? The question is what are the tips for coping with an ongoing risk of relapse? That you know it's like a sort of democless hanging on your on your head. I think we all are very cognizant of that the emotional impact of that. At the end of the day I still think it's the empowerment of the patient that would really help the patient to cope with this emotional strain. Again this is something that we can possibly help but we cannot you know at the end of the day it's a patient who is actually experiencing that stress. So empowering the patient to cope with that is going to be the biggest benefit that we can potentially deliver. I think the most important empowering element is the knowledge that if you know that what's your risk of relapse. If you have a very favorable disease then your risk of relapse is way low. So of course you know the stress is much less. Many of them can be quantified to an extent because with accumulative knowledge it can be quantified to an extent. In some patients with acute promyelocytic leukemia, if they're in remission now the chance of relapse is extremely low. Right it's less than 10 percent less than 5 percent. Right so or on the other hand the other group of so-called good risk acute myelogenous leukemia Corbine effector acute myelogenous leukemia. Now the relapse rates are more in the range of say 30 percent or you know 30 40 percent as a ballpark number. Whereas if you're on the other extreme in the adverse risk your chance of disease coming back is possibly close to 50 to 70 percent. Right but having that knowledge is important instead of kind of trying to figure out time to come up with a number to the chance of relapse. Right so that way if you know that information and the other thing is that how well you responded to the treatment. What's your situation about the minimally residual disease? When they look at the disease in a deeper way either by looking at the mutations by PCR technique by flow cytometry if there's very little detectable disease then of course your chances of relapse are much lower. And this is not one point it's not like a snapshot that over time over a period of two or three years the longer you're in a very very deep remission the lesser the chances of your disease coming back. Right and so that information having that information is important and so the patient also would need to ask that question to the treating physician that I'm in remission but how deep is my remission you know what's the quality of my remission. So and that discussion always I think would help the patient. The flip side of it is that if you have a higher risk of relapse if you know that you have a higher risk of relapse then the next question is going to be that how do I mitigate this risk? Can I get my should I get to a stem cell transplant? How early should I go for a stem cell transplant? Right or there are other maintenance strategies that can be there for not everybody is a stem cell candidate right you may be older you may have comorbidities you may not have a donor for that matter right but if there is a maintenance program that is showing some promise maybe I should get on that to mitigate my risk. So what I'm trying to say is that that that information having that information I think would be the most critical piece to cope and of course there are you know support groups that are available you know nowadays a lot of these are web-based they can be accessed and so and family plays I think I think the family plays a big big role and and it's not it's not a one-person fight you know it's a it's a fight with a team you know family is your team your treating physician is your team your nurse is your team your nurse practitioner is your team so you know again you know seeking help from the team when you need it truly helps I believe.